My New Lease on Life

Living a longer life with T1D

Jeremy back at the keyboard here, and I come to you with good news. I was just sitting here in lovely Del Mar, California catching up on my reading of Diabetes Care, when I was grabbed by one particular title. It reads, “Mortality in Type 1 Diabetes in the DCCT/EDIC Versus the General Population.” So I flipped to it, but I have to tell you, I was bracing myself for bad news. In my head I was thinking, “Awesome, another article about how people with type 1 die early.” Time to start drinking.

I don’t know about you guys, but I have lived my life “knowing” that people with type 1 diabetes live much shorter lives than the general population. I remember vividly sitting in class in med school on the day we talked about diabetes (yep THE ONE day). The lecturer was talking about all the horrible complications of T1D and then flashed up a slide showing how type 1s tend to live 10-15 years less than non-diabetics. I remember sitting in that class and thinking, “That’s not going to be me.”  But no matter how much I wanted to believe that, I also felt like I just got punched in the stomach. To make matters worse, two friends came up to me after class and told me how sorry they were- as if I had just been diagnosed with some awful cancer.

I would love to say that ever since then I have lived my life to the fullest and gone skydiving and 2.7 seconds on a bull named Fu Manchu, but really I’ve just lived my life like we all have, but just kinda thought it would end early.  It’s weird to write that. I didn’t even really know I felt that way, but I guess I did.

OK, so now back to this article (and the good news).  Things were getting kinda dark there for a minute. What this article did is follow all the patients in the DCCT study, which is the one that finally showed that good glycemic control drastically reduced microvascular complications. Participants were either “intensively” controlled to a goal A1c of 7 or did “usual care” with an average A1c of around 9. Now, these amazing people have been followed since the study ended in the early 90s, and we continue to learn A TON from them. What they found is that people in the intensive arm tended to live…….wait for it……. LONGER than people in the general population. OK, now it wasn’t statistically significant but there was a trend in this direction. To be honest, I don’t care about the longer part, but at least it’s not shorter!

A very telling graph from the article shows the range of A1cs vs. mortality rates, and what I make from the graph is that after about an A1c of 8.5% the mortality rates start exceeding the general population. So in other words, folks who had an average A1c of less than 8.5% over time had a mortality rate that was the same or lower than the general population. That’s pretty freaking good news if you ask me.

For me, this article is reaffirming what I’ve always wanted to believe. Namely, if we take care of ourselves, we can live normal, healthy lives- an important message. So get out there and live your lives, and if you come across a bull named Fu Manchu, send me a text cause I’m gonna ride the crap out of that thing.


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    Thank you for sharing that important study & finding. I too was traumatized from my first diabetic education class held on 11/21/1974 at Sarasota Memorial Hospital where I had been hospitalized on my 18th BD to start insulin. They casually threw out to the “3 diabetic students” that most would not live 43yrs with the condition. Now one student looked in his 60’s and had just had a leg amputated (probably Type 2), the other a 50 ish woman had just had a permanent port for dialysis for her failing kidneys….and me with the insane “I’ll live forever” philosophy that only late teens and early 20’s have….my life dashed to a few more good years. It set my crazy attitude of leaving for the University of Florida and devil be damned. I pushed life to the edge but in my late 20’s found my life partner, my time in San Diego (1985 to 1993) allowed me to be a patient of Dr. Dorthy Hollingsworth, an endocrinologist at UCSD who really put me on the track to learn how to live with my T1D and not fight it. My son was born at UCSD in January 1988. Dr. P & Dr. E thank you for carrying on the wonderful approach and optimism I found in Dr. Hollingsworth all those years ago. P.S. – still hanging in there with the Tandem X2 / G6 making yet another life changing point. A1C of 5.6 in 2021. I feel the 65yrs I’ve lived but I don’t feel constrained by the old actuarialntable of mortality for T1D.

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    Could you share the citation please for those of us geeky enough to want to read the original article (and lucky enough to have access to academic journals)?

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    I too was heartened by the study I recently read about good control and living a normal life span. Whew!
    Just type in the title of the article cited above. To see that study. There are others that show the same stats that were published earlier. We type 1s are , for good reason, paranoid when we hear the words “life expectancy “.

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    Valentines day is my D anniversery. 50 years in a couple of weeks. I was 17, BS 1000 full blown DKA. I feel that self managment is key to survival. My early years were more unknowns of my condition. Diabetes education and today’s technologhy is the tool of self management and survival. They have allowed me live longer. I’am sending a big thank you to diabetes educators and the developers of systems, i.e. meters, cgms and new insulins for providing the tools of survival. I do not want to be a statistic of death. I want to be a statistic of survival. Thank you for your post.

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